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Should Kids Play Football?

“Do your children play football?” I asked Kevin Guskiewicz the other day over breakfast. “Yes,” he replied, as I nearly fell off my chair. “My 16-year-old and my 12-year-old played football this year. They had a great experience.”

Guskiewicz is, among other things, the chairman of the department of exercise and sports science at the University of North Carolina here. His primary area of study is the connection between recurring concussions, depression and cognitive impairment. At their worst, these are symptoms of a degenerative brain disease called chronic traumatic encephalopathy, or C.T.E. Guskeiwicz’s research on the lasting damage repeated concussions can do to a football player’s brain helped convince the National Football League to tinker with the rules to make the game’s most dangerous play — the kickoff — a little less dangerous. He has been awarded a MacArthur “genius” grant and has been profiled by Malcolm Gladwell in The New Yorker.

Which is why I had naturally assumed that he would be opposed to children playing full-contact football. C.T.E. is a disease that used to be associated solely with boxers. (Indeed, it used to be called “dementia pugilistica.”) But over the past eight or nine years, researchers like Guskiewicz have been studying its effect on other athletes, especially football players.

Thanks not only to their work, but also to a rash of suicides by former (and in several cases, current) football players, as well as lawsuits that have been filed against both the N.F.L. and the N.C.A.A., the issue has gotten enormous visibility. Picking up on the news, many parents now don’t let their children play football because, after all, we all know it is too dangerous. Don’t we?

As I discovered after talking to a number of brain researchers who are studying C.T.E., the science really isn’t able to make that definitive claim — at least not yet. What we know for sure is that multiple concussions can lead to C.T.E. Dr. Ann McKee, a co-director at Boston University’s Center for the Study of Traumatic Encephalopathy, recently published a study with colleagues that examined, posthumously, brain samples of 85 people who had repeated mild brain trauma as opposed to concussions. Some 80 percent of them, the study found, showed evidence of C.T.E.

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Joe NoceraCredit
Fred R. Conrad/The New York Times

Does this mean that football players are more likely to get C.T.E., just because of the relentless pounding they take? Yes, says McKee: “Exposure to the sport itself is associated with this disease.”

Guskiewicz, however, is not yet convinced. “Studies like that clearly show that C.T.E. exists in players without a history of concussions, but they haven’t completely connected the dots. It’s a little like saying that if there are a rash of ankle sprains on a tennis team, and they all wear Nike tennis shoes, then the tennis shoes must be the culprit.”

“I always use the word ‘recognized’ when I talk about concussions,” said a third researcher, Dr. Robert Cantu, who is also a co-director of the Boston University center. After all, he says, in the bad old days — which is really just a few years ago — team doctors often missed signs of a concussion. “If you are convinced that players without a history of concussions really didn’t have concussions, then yes: repetitive head-banging alone can cause C.T.E.,” he says. “But we also know that some 80 percent of mild concussions go unrealized.” Still, he said, “Our data is showing that it is not just recognized concussions but total brain trauma that counts.”

When I asked Cantu if he believed that kids should be allowed to play football, he practically growled at me. “Haven’t you read my book?” he asked. Entitled “Concussions and Our Kids,” and published just a few months ago, it argues that children should be confined to touch football until they turn 14. “The young brain is more vulnerable,” he said. “Besides there is just too much that we don’t know yet.”

So why does Guskiewicz disagree with Cantu — a man with whom he has co-authored many a paper on C.T.E.? Like many people who study C.T.E., Guskiewicz is a football fan. Although there are those who now advocate abolishing football altogether — a pipe dream if ever there was one — his goal is to help make the game safer. Part of that, in his view, is teaching proper techniques that protect the head. “I worry that if we don’t teach the right way to block and tackle early, by the time they get to high school — which is when the physics of the game really changes — it will be too late,” he says.

And what does McKee think about children playing football? When I posed it to her, I could hear her sighing over the phone.

“I’m really conflicted about that,” she replied. Aren’t we all?

A version of this op-ed appears in print on December 15, 2012, on page A23 of the New York edition with the headline: Should Kids Play Football?. Today's Paper|Subscribe